NCLEX questions for management exam 1

The nurse should plan which goals of the termination stage of group development? Select all that apply. 1. The group evaluates the experience. 2. The real work of the group is accomplished. 3. Group interaction involves superficial conversation. 4. Group members become acquainted with one another. 5. Some structuring of group norms, roles, and responsibilities takes place. 6. The group explores members' feelings about the group and the impending separation

1,6 Rationale: The stages of group development include the initial stage, the working stage, and the termination stage. During the initial stage, the group members become acquainted with one another, and some structuring of group norms, roles, and responsibilities takes place. During the initial stage, group interaction involves superficial conversation. During the working stage, the real work of the group is accomplished. During the termination stage, the group evaluates the experience and explores members' feelings about the group and the impending separation.

The staff members working at the trauma center have characterized their nurse manager as task oriented and directive. Which leadership style does the nurse manager exhibit? 1. Autocratic 2. Situational 3. Democratic 4. Laissez-faire

1. Autocratic

It is 630pm and you receive a call from a newly hired nurse who is scheduled to work at 700pm. She tells you (the charge nurse) that she is sick and will not be able to come in. What should you do? 1. Inform her that 30 minutes is insufficient time to find a replacement, so she will have to come in. 2. Instruct her that she must speak to you the next time she comes in and attempt to find someone to replace her for this shift. 3. Document in her file that she failed to give adequate notice for calling in sick. 4. Tell the oncoming charge nurse that the new nurse called in, so the staffing will be short for the evening.

2 You should talk to her first to give her a verbal warning; she must acknowledge that she understands the call-in parameters. Explain that this type of behavior jeopardizes her probation status and that next time the incident will go into writing. Forcing an employee to come in during illness is not good for the other employees or patients. You may have to tell the oncoming nurse about the short staffing, but make every effort to find a replacement. Working short staffed is not safe or pleasant for anyone.

Relationship management is a key leadership skill because: 1. Being liked by staff makes it easier to get things done. 2. Patient care requires a high degree of interdependence on other care providers. 3. Transferring negative moods to staff can decrease productivity. 4. Helping staff cope with change is important.

2.

The graduate nurse is interviewed by the manager of a unit and is told that the manager's leadership style is laissez-faire or one of letting the staff nurses make the decisions about the unit's operations. Which question by the graduate nurse indicates the best understanding of the laissez-faire leadership style? 1. "As the manager, do you maintain control and make all decisions?" 2. "As the manager, do you assume a passive, nondirective approach?" 3. "As the manager, do you facilitate decision making within the group?" 4. "As the manager, do you change style according to the needs of the group?"

2.

The nurse manager meets with the staff nurses and announces that management has developed a new policy and procedure that is significantly different from old practices. Which statement by the nurse manager reflects the manager's use of legitimate power? 1. "The health care system services a client population that presents particular challenges. The changes made will enhance client safety and reduce errors." 2. "If you don't follow the new policy and procedure, I'll have no choice but to give you a notice about poor performance, which could lead to termination of your employment." 3. "Every manager has the responsibility to see that these new policies and procedures are followed 100% of the time. Please join me in this organization's effort to continue to improve quality care." 4. "You're just going to have to trust me on this one. I was a member of the committee that wrote the policy and procedure, and there are good reasons why the specific nursing actions need to be done this new way."

3 Rationale: Option 3 describes legitimate power. Legitimate power is based on a person's position within an organization or society. The organizational leadership has mandated performance outcomes, and management has the responsibility to see that the mandate is met. Option 1 demonstrates informational power. The manager is using data to drive compliance with the mandate. Option 2 reflects an example of coercive power. Coercive power is a "do this or else" type of approach. Option 4 reflects expert power. The manager is asking the staff nurses to comply with the mandate because the manager possesses expert knowledge and skill levels. In addition to coercive, informational, expert, and legitimate power, the manager has referent, reward, and personal power.

The nurse is seeking a leadership style that will empower staff to achieve excellence. Which leadership style should the nurse select to achieve this goal? 1. Autocratic 2. Situational 3. Democratic 4. Laissez-faire

3. Democratic

In an effort to improve glycemic control of hospitalized patients, a hospital puts together a team of doctors, nurse managers, nurses, and pharmacists. The goal of the group is to implement a standardized glycemic management protocol to be used throughout the hospital. This type of a team is an example of a: a. Primary work team b. Leadership team c. Ad hoc team d. Dysfunctional team

C

The nurse manager calls a meeting of unit staff members to discuss ways to improve the timeliness of patient discharge. The nurse manager and group decide that the use of an admit/discharge nurse would help improve patient flow. This is an example of what kind of decision procedure? a. Autocratic b. Consultative c. Joint d. Delegated

C

The executive leadership team's recommendation of increasing the nurse-to-patient ratio spurred the nursing staff to develop creative staffing strategies. These strategies included utilizing an acuity tool to make patient assignments. This is an example of what type of conflict? a. Competitive conflict b. Constructive conflict c. Disruptive conflict d. Intrapersonal conflict

Correct answer: b Rationale: Constructive, or functional, conflict stimulates creativity and innovation. In this scenario, the decision to increase the nurse-to-patient ratio lead the staff to develop a creative solution that would not only cut costs but preserve patient care and safety. Competitive conflict involves following rules to win or beat an opponent. Disruptive conflict is designed to attack, defeat, or eliminate an opponent. Intrapersonal conflict involves conflict from within an individual.

A hospital's executive leadership team wants to increase nurse-to-patient ratios in an effort to decrease costs. The staff nurses are against the change because they feel they already have difficulty completing care for their patients. Adding more patients to their assignment will decrease quality, safety, and patient satisfaction. This is a type of what kind of conflict? a. Intrapersonal conflict b. Intergroup conflict c. Intragroup conflict d. Relationship conflict

Correct answer: b Rationale: Intergroup conflict occurs between two groups. In this scenario, the executive leadership team and the staff nurses are the two groups involved in conflict over the nurse-to-patient ratios. Intrapersonal conflict is conflict that arises from within an individual (e.g., competing home and work obligations). Intragroup conflict is conflict within a group (e.g., the executive leadership team disagrees about increasing the nurse-to-patient ratio). Relationship conflict occurs when there is an awareness of interpersonal incompatibilities.

The Humanizing Nursing Communication Theory: a. Is a theory that involves nurse-to-nurse communication. b. Centers on conflict management. c. Patients are barriers to transformational process d. The vision of change should be communicated to employees.

Correct answer: d Rationale: Kotter (1996) suggested the following are needed to empower people to make change: communicate the vision to employees, make structures compatible with the vision, provide the training employees need, align information and personnel systems, and confront supervisors who undercut needed change. Kotter's model is not a theory and it does not focus solely on nurse-to-nurse communication. Kotter's model does not center on conflict management, but it does believe that supervisors, not patients, can be a barrier to the change process.

Which of the following statements regarding communication is not true? a. Communication is an essential skill for leaders. b. Effective communication can motivate and engage others. c. Poor communication affects care coordination. d. Communication is easy to measure

d Rationale: Communication is not easy to measure and therefore requires the development of more standardized tools. Communication is an essential skill for leaders who must communicate their vision and expectations in a clear, structured, honest manner. Effective communication can motivate and engage others while ineffective communication can lead to poor patient care.